Canadian recipients of the AstraZeneca COVID-19 vaccine were greeted with yet another shift in Canada’s recommendations for the jab on Thursday when officials said they’re not just allowed to receive an mRNA vaccine as their second dose — it’s actually preferred.
The latest advice comes after months of bad press for the embattled COVID-19 vaccine, which, despite the fact that it is still considered safe and effective, has seen its distribution seriously ramped down in Canada.
But in other countries, AstraZeneca is king — it remains one of the U.K.’s crown jewels in their vaccine rollout. Several other nations have also lapped up doses.
So why isn’t Canada equally enthusiastic about the jab? Here’s what we know.
Why isn’t Canada widely recommending AstraZeneca?
The National Advisory Committee on Immunization (NACI) said Thursday that Canadians who received AstraZeneca as a first dose should aim to get an mRNA vaccine for their second dose — which means either the Pfizer or the Moderna COVID-19 vaccine.
This left the droves of Canadians who initially jumped at the chance to get a COVID-19 vaccine feeling confused and uncertain.
“Some people feel shortchanged or some people feel that, you know, they might have got a second-class vaccine,” infectious disease specialist Dr. Isaac Bogoch told Global News Friday.
“I think it’s fair to say that that’s not really accurate. The data emerging from the United Kingdom is pretty impressive.”
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Canada did not come to the decision to phase out the use of AstraZeneca because the vaccine got worse or became significantly less safe, officials said.
Rather, Chief Public Health Officer Dr. Theresa Tam said Thursday that current evidence pointed at a “better immune response” when a first dose of the AstraZeneca vaccine was followed by either Pfizer or Moderna.
On top of that, Canada has so many mRNA vaccines doses that we now have the luxury of choosing to prioritize the jab with no risk of the extremely rare clotting side effect, Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), which AstraZeneca carries.
“In terms of being able to wait for a preferred vaccine, at this point, we’re kind of hitting that,” said Dr. Zain Chagla, an infectious disease specialist.
“We’re in a very luxurious position.”
“But again, there are many places in the world that don’t have that context, and the first vaccine they can get is probably the most appropriate vaccine.”
Prime Minister Justin Trudeau said Friday that Canada is on track now to have 68 million doses delivered by the end of July, which is more than enough to fully vaccinate all 33.2 million Canadians over the age of 12.
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Previously Canada expected enough doses to fully vaccinate 75 per cent of all eligible people before August, but Moderna has now scheduled another 11 million doses to be delivered in late June and early July.
“In Canada, we’re in a unique situation where we have a massive supply of mRNA vaccines, more than enough to vaccinate everyone,” Dr. Matthew Miller, assistant dean at McMaster University’s department of biochemistry and biomedical sciences, told Global News.
“And so, although the risk of VITT with a second dose of AstraZeneca vaccines is much lower than (with the) first dose, in the context of our declining case numbers of COVID-19 and the huge supply of mRNA that we have, it makes much more sense in the Canadian context on a risk-management basis to offer a vaccine for which we have no evidence of VITT.”
What are other countries doing?
Canada has had an incredibly aggressive vaccine procurement strategy that recently allowed us to become second to none in the share of national populations vaccinated against the novel coronavirus.
But while Canada has the luxury of choice, other countries have forged ahead with a buffet of safe and effective vaccines in order to get their populations inoculated as quickly as they can.
The United Kingdom was the first country to approve the AstraZeneca vaccine, and it quickly paid off in terms of its ability to vaccinate swaths of its population. England was able to open up its COVID-19 vaccinations to everyone aged 18 and up as of Friday, a step towards its government’s goal of giving the entire country a first dose within the next month.
Britain has given a first dose of COVID-19 vaccine to more than 42 million people, almost 80 per cent of adults, while well over a half have received both shots.
On top of that, the health service in England will open up COVID-19 vaccinations to everyone aged 18-plus on Friday, a big step towards the government’s target of giving every adult who wants a vaccine a first shot within the next month.
“Tomorrow is a huge milestone because everybody aged 18 and above can book their COVID vaccination,” said the head of NHS England, Sir Simon Stevens, speaking Thursday.
“Already over three million in their 20s have had their first jab and so everybody tomorrow can now follow on their footsteps and get that protection. Not only for you and your friends, but also for your neighbours in a way that will keep us safe and hopefully give us back our summer.”
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However, the U.K. still isn’t giving AstraZeneca to everyone. Officials have said that people under age 40 should be offered an alternative to AstraZeneca’s shot, due to the link to VITT.
Australia has also shifted some of its guidance on AstraZeneca — and it has done so more than once.
In April, the country recommended people under the age of 50 should be offered an alternative to the AstraZeneca vaccine. But on Thursday, Austalia bumped that age limit up to 60.
“We think we are picking up more cases of [VITT] than just about anyone in the world, because our doctors are so good in picking up the large number of people who have actually very mild conditions, particularly those in the older age group,” said Australia’s Department of Health Secretary, Brendan Murphy.
Australian Health Minister Greg Hunt added that there are other countries that have been “far more forward-leaning” in the use of AstraZeneca, citing the U.K. as an example.
He added that AstraZeneca is being given to anyone over age 30 in South Korea, and there are “no age limits within the prescribed range in Germany whatsoever.”
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Australia has administered 3.3 million doses of the AstraZeneca vaccine, and it has been linked to 60 cases of blood clots. So far, two people have died.
The United States, meanwhile, never actually approved the AstraZeneca vaccine, citing sufficient supply of other jabs as negating the need for yet another vaccine option, according to Dr. Anthony Fauci.
Should I have doubts about AstraZeneca?
Despite the shifts in AstraZeneca advice as the science evolved, infectious disease specialists are clear about one thing: AstraZeneca is still a “really good” vaccine.
“The effectiveness of even a single dose of AstraZeneca (is) about 71 per cent in keeping people out of hospital, and two doses of AstraZeneca is having a 91 per cent effectiveness in keeping people out of hospital,” Bogoch said.
“People who received the AstraZeneca vaccine — congratulations, you’ve got a good vaccine.”
“It really does help protect you from COVID-19, including the more transmissible Delta variant, which is circulating in Canada.”
In fact, countries with the luxury of choice should take this as an opportunity to help others with their supply of safe, effective vaccines, Chagla said.
“We need to talk about our future with AstraZeneca. If people want to get their second dose of AstraZeneca right now, when the preferred vaccine is mRNA, fine, we can keep a small supply. But we really need to talk, from a global equity standpoint, what this means,” said Chagla.
“They can do a lot of good in other parts of the world where the pandemic is currently raging.”
–With files from Reuters, Global News’ David Lao
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